Humanitarian doctors worked all day only to have their patients slaughtered at night

LONDON (Thomson Reuters Foundation) - Samantha Bolton was based in Nairobi, working as the regional information officer for Medecins Sans Frontieres (MSF) when the Rwanda genocide started in April 1994. She recalled how Rwanda’s 100 days of killing took the world by surprise and describes the ethical quagmire facing aid agencies in the aftermath.

"I'd been to Rwanda in January. Already then you had the sense that the militias, or Interahamwe, were preparing.

"For example, there was this one road that cuts across Kigali. You had U.N. peacekeepers on either side. The Interahamwe stopped the MSF car - I had a bunch of journalists in there - and started shaking it, and burning tyres. They were just testing the reaction of the U.N. troops who of course did nothing, because their mandate was to only react if they were attacked. It was really tense.

"Even when it started, no one was thinking genocide. Just defining it was a big deal. When is a genocide a genocide, versus a big massacre? It took a while for MSF and ICRC (International Committee of the Red Cross) to come out and call it that. It's such a strong word. It requires immediate international intervention. When we did start saying it, the big U.N. organisations and the diplomats weren't happy because it meant they had to do something.

"I got on well with the local MSF staff and they would tell me: ‘They've made lists, they've made lists. The radio operator is in with these people.’

"I remember filing a report saying they're saying this, and that was that. You think it's their paranoia after years of ethnic clashes. Then in fact, when it started it was true.

"Our radio operator, who controlled everything, where all the cars were going....ended up being the one giving instructions to the Interahamwe. Many say he helped kill other staff.

"When it started, we all went down to the airport in Nairobi waiting for our international staff who had been evacuated. Right at the beginning, just after the Rwandan president’s plane was shot down on April 6, this plane of dead Belgian peacekeepers landed. I remember the stench. They were slashed to pieces, all over their bodies like a zebra.

"That's when people realised this was serious. As our staff arrived, they told horrific stories of convoys being attacked, how those who were married to Tutsi women or men were taken off the convoys. If their partners didn't have a Belgian or a French passport, they were taken away and some of them were killed.

"We spent the first week or so at Nairobi airport listening to stories, asking people what they heard, trying to piece together what was happening.

"The weird thing about the genocide was that the telephones worked the whole time. A lot of people had my number because I was the information officer so I would get calls from the staff. Because they worked for an international NGO, their relatives would often bring them their children and leave them.

"There was this one woman who kept calling me. She said: 'I've got 10 nephews and nieces,' and every day the Interahamwe would come and ask her which one she would choose to be killed.

"She gave them all her money and jewellery, everything she had to spare them, until she had nothing left. She had to choose one of the children. Every day the Interahamwe would kill one in front of all the others. She was absolutely desperate and she would phone me and say: 'I beg of you, I beg of you.'

"MSF later went back into Rwanda with a surgical team. The doctors would work all day and then the Interahamwe would come and just kill the patients. Not even hospitals were sacred. For the first few weeks we couldn't say anything about patients being killed because for security reason we were under the ICRC flag, but the ICRC did speak out and still the world did nothing.

"Another problem we had was with the nurses. There were nurses from all sides but in the war, some of them would let the patients die.

"Around 800,000 Tutsis and moderate Hutus were killed in the genocide, mostly with machetes. There were so many amputees, women and children coming in with their noses chopped off or hands. Post-surgery, they would have a fever but the nurses wouldn't give them the drugs. Many would die in the night shift.

"The genocide happened in the same year South Africa held its first post-apartheid elections, in April 1994. Foreign journalists thought they would have a story with blood and violence and they didn't. Everything passed off happily. Then they became aware of what was happening in Rwanda and suddenly started coming to Tanzania and then Congo where the refugee camps were. That’s why the Great Lakes crisis and refugee exodus and camp story hit the headlines overnight.

"There were over 2 million refugees in 35 camps in the countries around Rwanda. When cholera broke out, 50,000 died in a few weeks. But right from the start, there were areas in the north of the camp in Goma, in Congo (then Zaire), where you couldn't go at all - it was too dangerous.

"You could see the militia soldiers training. They would be jogging and marching with their clubs and machetes. You could see they were killers. Their eyes were dead, their souls gone. This was where the leaders were. There was absolute impunity. They did whatever they liked and they got bolder and bolder.

"We knew the militias were stealing food because the numbers didn't work out. We had high levels of malnutrition in the clinics but with the amount of food being distributed, they should have all been overweight. It was all going to the north, and feeding these soldiers and stocking up probably for the war that eventually happened when they went further into Congo.

"We started documenting and speaking out about how the camps and aid were being used as a rear base to feed the killers and fuel another conflict, and that's when MSF came out and said we've got to pull out of the camps."

By December 1995, all MSF teams had pulled out of Goma’s refugee camps. MSF's "Speaking Out" website provides more information on the refugee crisis and the ethical dilemmas it created